Washington District of Columbia

Michael Shiner's Death Certificate Furnished by : John G. Sharp

{Form No.3} No 22895 CERTIFICATE OF DEATH TO THE HEALTH OFFICER, DISTRICT OF COLUMBIA Permit No 22919 Date of Death, Jan 17 1880           Full Name of Deceased, Michael Shiner Sex, Male Age, 75 Years - Months [blank] Days [bank] Color,     C Married, Occupation, Watchman Birthplace, MD Duration of Residence in the District of Columbia, Nearly all life Place of Death [Give Street and number] 338- 9th Street S.E. First (Primary) Causes of Death Duration, Small Pox ( Confluent) Second (Immediate) Duration of Last Sickness [blank] Place of Burial Beckelts Date of Burial, Jan 17. 1880 A.A. Maistelln , M.D. Address, 218 3 St NW Undertaker Geo. C.H. Bates Place of Business [blank]

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